Hi, I was wondering if there is anyone who has or is in a similar situation to me?
I have had an immidiate TUG after an mx nearly three weeks ago and have now been told they found more cancer than they initially saw and I will need a three week course of Rads.
I have my initial appointment with my oncologist in two weeks but when discussing the type of reconstructive surgery I could have, I remember someone saying, “well you don’t need any therapy so this will be okay”.
Now I am thinking, perhaps Rads is not good after this type of reconstruction. Although my flap is healing fine, the skin on my breast is not healing that great, scabs, blisters and oozing 
I wouldn’t dream of having any therapy until this has healed, but I am not a doctor or nurse so guess it probably wouldn’t be my decision.
Has anyone else had Rads after a recon and if so how long after surgery until the start of your plan and was everything ok?
Thank you
x
Hi Toni
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Best wishes
Lucy
Toni - your first priority (and that of your team) is to try and stop the cancer. Radiotherapy is very good at the job.
Having said that, every woman should have the option of the best recon she can have. I am just researching my own recon options and attended a BCC recon session yesterday. The oncoplastic surgeon said that rads may harden and/or shrink a reconstruction. However, she was very clear that did not mean the end of the world and you would still have options for further surgery to try and improve the result later if you do have problems. The latest thinking seems to be that it is better to wake up with a breast, even if you need surgery again later. So, people are getting recon even when they know they need rads. Everything changes very quickly in the world of BC, so ask for an appointment with the surgeon (not just your Onc) and find out your options.
Good luck healing up enough to have the rads you need, xxx
Hi toni
I had an immediate recon with tissue expander and strattice. I decided to have rads afterwards though I was told it wasn’t strictly necessary. I think rads can affect reconstructions particularly implants however as Cressida says it can be done.
I’d suggest to really look after your skin during rads. I used marigold cream as I’d read that it’s recommended in the states. The other thing to say is that in my experience they like to press on with rads even if you are not totally healed-6 weeks was the max they wanted between surgery and rads. However the radiotherapy staff told me they do go up to 12weeks…
Good luck xx
I had an immediate reconstruction with a Becker tissue expander. With implants like mine, rads can cause capsular contraction, but it may not and if it does I can have surgery to fix it.
If you need RT, just go for it.
Hi all, thanks so much for replying, its so nice to hear others thoughts and tips.
I know if I have been advised to have rads, then I really should have it, I’m just paranoid that it may ruin what I have had done by way of my reconstruction. I mean if it wasn’t for the not healing how it should, it’s a pretty damn good boob! I even panicked when they took my tape off yesterday, thinking my flap was going to fall off!
My main priority is getting rid of the damn disease and like Cressida and BlackSwan have said, it can be fixed later if need be! I didn’t think I was vain, but the look of my boob seems to come first with me rather than the cure (And know this is wrong). I don’t understand why, I’m no page 3 model, they weren’t that great to start with, I mean after three children, whose would be?!
Thanks Sukiem for the tip on Marigold cream, I will definitely be looking it up.
(Thanks also Lucy).
Toni
x
Hi Tonit3,
I chose to have the TUG recon rather than an implant because i knew I would need rads. I was told that an autologous reconstruction would respond much better to RT than an implant due to risk of capsular contraction and did not want to postpone reconstruction as i may well be self employed in 3 months time. The plastic surgeon did not think it was a problem to have immediate recon and said there was some risk of shrinkage and perhaps of the fat becoming a bit lumpy but that this could be remedied with lyposuction. He recommended copious amounts of ice-cream.
I’m about 2 weeks behind you in surgery terms and have an appointment with the oncologist tomorrow. This all seems very soon to me as my wounds feel fairly fresh and i have cording preventing me moving my arm sufficiently, but I guess they like to get the planning done. I’ll let you know if i get further info.
How’s the leg?
PS i breast fed 4 kids including twins, so Thighadora is way up high compared to Brunhilda. I’d got used to my breasts being a bit loose! I’ve been offered a breast lift so that they match, but am not sure I want Brunhilda desensitised for the sake of cosmetic surgery. Has this been suggested to you?
Hi ad astra
Thanks for the advice. I had my appointment with my oncologist yesterday, they said everything should be fine, but until my boob healers, they won’t touch me. They seem to think its going to take at least another two/three weeks. Although today I had a call from their department wanting me to come in for a CT scan next week, so I guess not all the information was passed over. CT scan will also have to wait.
With regards to the tattooed dots used for alignment, you can apparently ask for these to be below your top line, rather than above.
I am still unable to fully move my arm, mainly stretching it out wards and then going to raise it, I can only go shoulder high so I will have to work on that beforehand otherwise it could be a painful 15 minutes of rads.
I was just offered liposuction if they couldn’t get enough donor from my leg to make up my boob. This looks like it should be fine, although its gradually shrinking as the swelling is going down. I hadn’t actually noticed if it was lower/higher than my other boob - until yesterday when I read your post. Yeup, it’s probably about 3/4" - 1" higher than my good boob, damn! Lol.
Hope you got on ok with your Oncologist today.
Toni
x
Hi Toni
I’m 3 years post mastectomy and DIEP flap reconstruction done at the same time.
After my surgery was informed the cancer reached the borders of excision and should have radiotherapy.
I was concerned about the effect it would have on my reconstructed boob, never the less i was more concerned about the cancer not being completely removed and had 15 sessions of radiotherapy just 4 weeks after my surgery with no problems.
I was given aqueous cream by the radiotherapy team to keep the skin in good condition and it worked.
I had more problems last year following a mastapexy of my other boob and aeriola share, that did not heal very well and have been left with worse scaring than my reconstructed boob which has hypertrophied.
Viv x
Hi Toni and Viv,
Thanks for the further information. It was reassuring to hear that you had no problems, Viv, with the RT, although I’m sorry that that the mastopexy has not been entirely successful. I hope the scar fades with time and continued massage. I think it’s very difficult to weigh up the pros and cons of this procedure. I have so many numb bits now and really dont like the alien sensation when my dead inner arm touches my reconstructed breast, so I’m loathe to desensitize any other part of me. One breast is high and small due to having had quite a bit of skin removed. I had been hoping, that with an autologous reconstruction, i would get a more natural breast for my age and history. However, I may have to get used to “the odd couple” and strive for looking ok with clothes on!
I too will try marigold and acqueous creams. My RT planning was postponed due to inadequate arm movement but this has improved with physio and i expect to get the go ahead this Thursday. I’m surprised at how tiring the physio exercises seem to be. Achieving so little, seems to be so strenuous!
Having listened to the odds, I didn’t find the decision regarding RT difficult. I’m sure everyone’s prime concern is to be cancer free. However, having been on such a long journey and having gone down the reconstruction route, it’s understandable to want to get a good cosmetic result. Apart from the issues of vanity and sexuality, I want to go back to work feeling confident rather than freaky.
Good luck!